Rethink Statins

Who should take them?

Doctors have traditionally used age to determine if a patient should take statins to lower heart attack risk, but that approach excludes many people who could benefit from them.

A new way to determine who should receive statins could improve prevention of heart disease, especially in younger people, a study finds.

[Related: A New Era in Cholesterol Drugs]

“Our study is changing the way we think about prescribing statins; we should not only be considering who is at risk of heart disease but, more importantly, who would benefit from these medications,” said George Thanassoulis, associate professor of medicine at McGill University.

“For example, younger patients who have high cholesterol are frequently considered too young to be at risk for heart attack in the short term, but our analysis shows that they would benefit from treatment, even in the short term, and therefore should be eligible for statin treatment.”

For a new study published in the journal Circulation, researchers used data from 2,134 participants from the National Health and Nutrition Examination Survey—a nationally representative U.S. cohort, between 2005 and 2010, representing 71.8 million Americans potentially eligible for statins.

Researchers compared two approaches for statin eligibility: a 10-year risk based approach that is currently in use, and an individualized benefit approach. They found the latter method produced greater eligibility.

“Using a benefit-based approach, we identified 9.5 million lower-risk Americans not currently eligible for statin treatment, who had the same or greater expected benefit from statins as higher-risk individuals,” Thanassoulis said.

[Related: Racial Differences for Inherited High Cholesterol Exposed]

“These individuals were lower-risk because they were younger, but they also had higher levels of low-density lipoprotein cholesterol, which we have known to be an important cause of heart disease. Targeting statin treatment to this group would prevent an additional 266,000 heart attacks and strokes over 10 years.”